Sexual Influence on Bone Metabolism in Uremic Patients on Regular Dialytic Treatment

Luisetto, Giovanni; Bertoli, M

doi:10.1159/000187917

Cited by 18 publications

(9 citation statements)

References 31 publications

(31 reference statements)

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“…The difference in these results is probably due to heterogeneity in the etiology of renal failure and/or differences in treatment. The difference in sensitivity to parathyroid hormone may be one of sex difference [5].…”

Section: Discussionmentioning

confidence: 99%

Changes in bone mineral density at various sites in patients on hemodialysis due to chronic glomerulonephritis

et al. 1997

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Section: Discussionmentioning

confidence: 99%

Changes in bone mineral density at various sites in patients on hemodialysis due to chronic glomerulonephritis

et al. 1997

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“…Although in both sexes a significant positive correlation was observed between PTH and bone GLA protein, the slope was higher in females, even though not significant. Authors have suggested that their results have indicated that the uremic females show an increased skeletal sensitivity to PTH, probably due to the lack of protective effect of estrogens [44]. Some other studies have shown a more pominent deficit in BMD in female ESRD patients.…”

Section: Gender Differences and Hormonal Factorsmentioning

confidence: 99%

Osteoporosis in the elderly with chronic kidney disease

Ersoy

2006

Int Urol Nephrol

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Considering the aging dialysis population of today, increasing our knowledge about the nature, diagnosis and the treatment of bone mineral density (BMD) problems in end-stage renal disease (ESRD) patients deserves more attention. Osteoporosis is basicly defined as a decrease in bone mass. Large epidemiological studies in general population have identified several risk factors for osteoporosis including advancing age, female gender, white race, decreased calcium intake, gastric acid suppression therapy, sedentary lifestyle, premature loss of gonadal function, decreased estrogen secretion, thin body habitus, decreased physical activity, cigarette smoking, alcohol abuse, excess glucocorticoid exposure, and possibly some genetic factors. Osteoporosis in ESRD patients is only a part of a wider spectrum of metabolic bone problems, namely uremic osteodystrophy. Therefore, its diagnosis, management and follow-up may differ from the general population and an individualization of diagnosis and definition for dialysis population may be necessary. However, standard diagnostic tools such as dual energy X-ray absorptiometry (DEXA) have been widely used for the assessment of bone mineral deficiency status in ESRD patients. Regardless of the methods, most of the studies are in concordance with a reduced BMD in HD and PD patients. Dialysis patients are known to be at increased risk for low-trauma fractures. Thinning of cortical bone, which is responsible for the largest contribution toward reduced bone mineral content in chronic renal failure results in increased fracture risk. In either normal population and dialysis patients, fracture risk is increased with age. But in dialysis patients, besides age, several other factors may also affect the degree of bone mineral deficiency, and age-BMD relationship may be blunted. Female sex, in hemodialysis patients is negatively associated with total hip BMD. While several studies have been unable to demonstrate any association between BMD and PTH levels, larger body size has been shown to have a significant positive effect on BMD in both hemodialysis and peritoneal dialysis patients. Although they have been used in small groups of chronic kidney disease (CKD) and ESRD patients, because of their potential nephrotoxicity and hypocalcemic effects, use of biphosphonates in renal patients is questionable. Currently, bone biopsy, in order to exclude adynamic bone disease is recommended before beginning treatment with bisphosphonates in chronic kidney disease and dialysis patients.

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“…Female hemodialysis patients have been reported to have lower BMD values than males, probably as a result of fluctuations in the menstrual cycle [ 34 , 35 ]. In female ESRD patients, the skeletal sensitivity to PTH was increased compared with male patients [ 36 ]. The bone microarchitecture deteriorated to a greater extent in female ESRD patients than in males, and the reduction in trabecular parameters correlated with the severity of hyperparathyroidism only in females [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Sex-specific relationship between vascular calcification and incident fracture in patients with end-stage renal disease

Nam

Hwang

Kim

et al. 2020

Kidney Res Clin Pract

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Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a clinical syndrome that describes a systemic disorder of mineral and bone metabolism caused by CKD. CKD-MBD includes biochemical abnormalities of calcium, phosphorus, parathyroid hormone (PTH), and vitamin D, bone disease, and vascular calcification (VC) [1]. The incidence of fracture increases as CKD progresses [2]. In the Dialysis Outcomes and Practice Patterns Study (DOPPS), across all countries studied the incidence of fracture was significantly higher in patients receiving maintenance dialysis compared with the gen

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Sexual Influence on Bone Metabolism in Uremic Patients on Regular Dialytic Treatment

Cited by 18 publications

References 31 publications

Changes in bone mineral density at various sites in patients on hemodialysis due to chronic glomerulonephritis

Changes in bone mineral density at various sites in patients on hemodialysis due to chronic glomerulonephritis

Osteoporosis in the elderly with chronic kidney disease

Sex-specific relationship between vascular calcification and incident fracture in patients with end-stage renal disease

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